MEDICARE: MARC CORRAO DC FAMILY CHIROPRACTIC CENTER INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	B-623	NV

General Provider Information

NPI Number	:	1417271321
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARC CORRAO DC FAMILY CHIROPRACTIC CENTER INC

Provider Business Mailing Address
First Line	:	5365 MAE ANNE AVE
Second Line	:	SUITE B-2
City	:	RENO
State	:	NV
Zip	:	89523-1840
Country	:	US
Telephone Number	:	775-324-3700
Fax Number	:	775-324-2370

Provider Business Practice Location Address
First Line	:	5365 MAE ANNE AVE
Second Line	:	SUITE B-2
City	:	RENO
State	:	NV
Zip	:	89523-1840
Country	:	US
Telephone Number	:	775-324-3700
Fax Number	:	775-324-2370

Authorized Official
Title or Position	:	OWNER
Name	:	MARC CORRAO
Credential	:	DC
Telephone Number	:	775-324-3700

Provider Enumeration Date	:	03/22/2010
Last Update Date	:	04/07/2010

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